Provider Demographics
NPI:1457679201
Name:LE, JESSE DINH (MD)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:DINH
Last Name:LE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 EAST ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2096
Mailing Address - Country:US
Mailing Address - Phone:925-609-7220
Mailing Address - Fax:
Practice Address - Street 1:2222 EAST ST STE 250
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-609-7220
Practice Address - Fax:925-689-3857
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120776208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology